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European Radiology

, Volume 30, Issue 1, pp 291–300 | Cite as

Baseline 3D-ADC outperforms 2D-ADC in predicting response to treatment in patients with colorectal liver metastases

  • Daniel Fadaei Fouladi
  • Manijeh Zarghampour
  • Pallavi Pandey
  • Ankur Pandey
  • Farnaz Najmi Varzaneh
  • Mounes Aliyari Ghasabeh
  • Pegah Khoshpouri
  • Ihab R. KamelEmail author
Magnetic Resonance
  • 84 Downloads

Abstract

Objectives

To examine the value of baseline 3D-ADC and to predict short-term response to treatment in patients with hepatic colorectal metastases (CLMs).

Methods

Liver MR images of 546 patients with CLMs (2008–2015) were reviewed retrospectively and 68 patients fulfilled inclusion criteria. Patients had received systemic chemotherapy (n = 17), hepatic trans-arterial chemoembolization or TACE (n = 34), and 90Y radioembolization (n = 17). Baseline (pre-treatment) 3D-ADC (volumetric) of metastatic lesions was calculated employing prototype software. RECIST 1.1 was used to assess short-term response to treatment. Prediction of response to treatment by baseline 3D-ADC and 2D-ADC (ROI-based) was also compared in all patients.

Results

Partial response to treatment (minimum 30% decrease in tumor largest transverse diameter) was seen in 35.3% of patients; 41.2% with systemic chemotherapy, 32.4% with TACE, and 35.3% with 90Y radioembolization (p = 0.82). Median baseline 3D-ADC was significantly lower in responding than in nonresponding lesions. Area under the curve (AUC) of 3D-ADC was 0.90 in 90Y radioembolization patients, 0.88 in TACE patients, and 0.77 in systemic chemotherapy patients (p < 0.01). Optimal prediction was observed with the 10th percentile of ADC (1006 × 10−6 mm2/s), yielding sensitivity and specificity of 77.4% and 91.3%, respectively. 3D-ADC outperformed 2D-ADC in predicting response to treatment (AUC; 0.86 vs. 0.71; p < 0.001).

Conclusion

Baseline 3D-ADC is a highly specific biomarker in predicting partial short-term response to treatment in hepatic CLMs.

Key Points

Baseline 3D-ADC is a highly specific biomarker in predicting response to different treatments in hepatic CLMs.

The prediction level of baseline ADC is better for90Y radioembolization than for systemic chemotherapy/TACE in hepatic CLMs.

3D-ADC outperforms 2D-ADC in predicting short-term response to treatment in hepatic CLMs.

Keywords

Liver neoplasms Colorectal neoplasms Diffusion magnetic resonance imaging RECIST 

Abbreviations

ADC

Apparent diffusion coefficient

AUC

Area under the curve

CI

Confidence interval

CLMs

Colorectal metastases

DWI

Diffusion-weighted imaging

HIPAA

Health Insurance Portability and Accountability Act

MRI

Magnetic resonance imaging

RECIST

Response evaluation criteria in solid tumors

ROC

Receiver operator characteristics

ROI

Region of interest

SIRT

Selective internal radiation therapy

TACE

Trans-arterial chemoembolization

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr Ihab R. Kamel.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Daniel Fadaei Fouladi
    • 1
  • Manijeh Zarghampour
    • 1
  • Pallavi Pandey
    • 1
  • Ankur Pandey
    • 1
  • Farnaz Najmi Varzaneh
    • 1
  • Mounes Aliyari Ghasabeh
    • 1
  • Pegah Khoshpouri
    • 1
  • Ihab R. Kamel
    • 1
    Email author
  1. 1.Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineBaltimoreUSA

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